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The Hay Fever Handbook
Posted By Sarah Elton On 2010/07/02 @ 1:50 pm In Pollen | No Comments
All you’ll need to cope with Spring’s misery-making allergies.
Debbie Honickman, a Toronto family doctor, never had hay fever as a child. Then in her forties, she started to react to grass in the spring, and could suddenly empathize with her allergy-suffering patients.
At first she found her symptoms so difficult “I thought, I can’t stand it!” Such was Honickman’s seasonal grief that she even contemplated leaving her province the following spring – “but I love the spring here because I love birding.”
She rhymes off her symptoms: “I feel congested, I have post-nasal drip, I snore more.” Honickman knows to expect a prolonged bout with ragweed in the fall as well – then a few years ago, she also developed allergic asthma. “I actually have to use an inhaler when my symptoms get bad. I had never had asthma in my life.”
As the grass and trees begin their spring pollinating ritual, many of us suffer with Honickman. More than five million Canadians have seasonal allergic rhinitis, commonly called hay fever. In fact, Canada has one of the highest rates of both allergic rhinitis and allergic asthma in the world, and the United States ranks only slightly behind.
The numbers of North Americans living with environmental allergies has risen rapidly. With so many suddenly suffering, Allergic Living offers this comprehensive guide – examining pollen’s havoc and the most effective means of turning off the weeping, the sneezing, the congestion and the misery.
What is Hay Fever?
As with other allergies, seasonal allergic rhinitis is an immune system over-response to a protein, in this case an inhaled pollen or a mould spore. Antibodies are supposed to protect our bodies, to defend, but the immune system of a person predisposed to allergy can mistakenly identify a certain protein – perhaps birch tree pollen – as an invader and begin to create antibodies against it.
These antibodies, which are called Immunoglobulin E or IgE, attach themselves to mast cells, which are abundant in the nose, eyes, lungs and gastrointestinal tract. When the offending pollen is again encountered, the IgE antibodies grab it, triggering the mast cells to release powerful chemicals, including histamine. This causes the allergic reaction.
Allergic rhinitis is often confused with irritant or non-allergic rhinitis, which is triggered by air pollution, smoke, strong odous or medication. Some people with hay fever or allergic rhinitis find that such irritants will further aggravate their allergic symptoms.
In hay fever, these are the itchy, watery, puffy eyes, runny nose and sneezing that are the stuff of medication ads.
When an allergic individual is exposed to a seasonal allergen, the chemical reaction begins: blood vessels dilate in the eyes and nose, the mucous membranes secrete fluids, and the itching and sneezing start. All this discomfort leads to sleep loss, fatigue, irritability and difficulty concentrating.
Sometimes the symptoms are confused with those of a cold. But Dr. Harold Kim, an allergist based in Kitchener, Ontario, says itchiness is a prime indication that allergies are the culprit. Another clue that it’s not a virus is that you won’t get better in a week or so.
“If symptoms are due to pollens such as trees and grass, they will last over a season,” Kim says. In addition, if the sufferer has asthma, he or she may experience shortness of breath, coughing or wheezing.
Next: How to Pollen and Mold-Proof
Wind and Wet
While the pollen season kicks off at about the same time every year, the actual levels of the allergenic stuff in the air change with the weather. This means that you won’t react the same way every year – or even every day.
Pollen levels are highest on warm, dry, breezy days when the wind easily carries small, light grains away from the plant and into your nose. On colder, wet and humid days, the moisture clings to the grains and they are more likely to remain on the ground. When this moisture evaporates, the pollen again becomes airborne.
Hay fever can start before buds even appear in your neighborhood. “Tree pollen often travels hundreds of miles,” says Dr. Paul Keith, an allergist and associate professor at McMaster University.
If you have seasonal allergic rhinitis triggered by molds, the peak months are July and August, though the season endures much longer. “Mold comes out when the snow melts and stays until fall,” says Keith.
Molds love moisture and can live in damp areas inside your house year-round. Molds are fungi, and reproduce by sending spores, which are tiny seeds. Like pollen, spores become airborne and can trigger allergies.
Sex and the Single Tree
For those behind in their botany, pollen is the male fertilizing agent of plants and grasses. As nature shows off in spring with blooming trees and flowers, species with large pollen grains rely on insects like bees to distribute their genetic material to mates. But plants with tiny grains of pollen cast it to the wind, relying on the breeze to transport their seed; these are the allergy culprits.
Pollen- and Mold-Proofing
While you can’t avoid pollen and mold altogether in spring, you can make life much more bearable by taking precautions inside and outside the home.
• First, DON’T open those windows! That lovely spring breeze will carry allergens inside. Once it’s warm indoors, use an air conditioner and make sure it is draining properly to avoid mould growth.
• DON’T hang out your laundry. The smell may be fresh, but pollen will be your bedfellow.
• DON’T dust and sweep when cleaning. Instead, wipe surfaces with a damp cloth and mop with water.
• DO use a vacuum with a certified HEPA filter to remove allergens from the air rather than blowing them around.
• If you’re not dander allergic and keep a dog or cat, DON’T cuddle your pet in peak pollination seasons. The animal’s fur may be laden with pollen.
• DO wash your exposed skin when you come inside, and take a shower to rinse pollen from your skin and hair before heading to bed.
• DO keep your home dry to discourage mold growth. Maintain your roof to ensure your home’s structure doesn’t get wet and stay wet.
• DO clear your eaves troughs of decaying leaves and twigs.
• DO fix that leaky tap and other sources of mold-welcoming moisture.
Next: How to Manage and Enjoy Spring Outdoors
Hay fever sufferers don’t have to be shut-ins – one must simply learn when it is best to go out.
• Stay inside when pollen levels are at their highest, generally between 5 a.m. and 10 a.m., when the morning dew is drying.
• Check local pollen forecasts before heading out, and ask a doctor for advice on when to take medications.
• Cool and damp conditions are good times to venture out – there will be less pollen in the air. If it is warming up after a rain, change plans. The pollen will become airborne as the water evaporates.
• Get someone else to mow the lawn if you are grass- or mold-allergic (the mower stirs up mold in the grass) and keep the lawn to two inches or less to prevent flowering. Don’t go outside if you hear the neighbor mowing during grass pollen season (May to July).
• Wear a face mask, hat, glasses, gloves and a long-sleeved shirt when working outside. This will keep pollen exposure to a minimum.
• Help yourself by making your garden as allergen-free as possible (and encourage neighbours to do the same). Spring-flowering trees such as cherry and apple are good choices as well as red maple, dogwood and magnolia; they rely on insects to pollinate. (See ‘Sneeze-Free Garden ’.)
Next: Finding Hay Fever Relief!
Relief in a Pill or Spray
After taking necessary avoidance measures, you will probably still need medication to help you get through the season. There are two types of over-the-counter drugs you can turn to: antihistamines and decongestants. Histamines in the body cause sneezing and itchy eyes. What antihistamines do is “block the histamine molecule from working, which reduces symptoms,” says Dr. Harold Kim.
It is recommended that you take antihistamines throughout the allergy season to stop symptoms before they arise. However, Kim does not advise taking antihistamines such as Benadryl on a daily basis because they are sedating.
For continuing daytime use, he prefers the newer, non-sedating, over-the-counter antihistamines (there are several brands). One treatment he favors is such an antihistamine used in tandem with a prescription nasal-steroid spray. Not all these antihistamines are suitable for young children, so consult your doctor before giving them to children with allergies.
Decongestants relieve the swelling associated with a stuffy nose by narrowing the blood vessels, which prevents blood from collecting in the nose. Decongestants are available over-the-counter in oral tablets, liquids, eye drops and nasal sprays. They may not be appropriate for the elderly or for cardiac patients, and Kim cautions that these sprays should not be used longer than three consecutive days to avoid dependence.
Nasal-spray decongestants should not be confused with nasal-steroid sprays such as Nasacort AQ, Flonase or Nasonex, which are applied in a similar fashion, but are suitable for long-term use in treating allergic rhinitis.
When Kim suggests a decongestant to his patients, he generally recommends a combination antihistamine/decongestant. For asthma patients whose allergic symptoms are worse in the spring or fall, Kim suggests speaking to your doctor about increasing your steroid inhaler dosage or switching to an inhaled dose that’s a combination long-acting bronchodilator and steroid.
But even if your hay fever has been bad, it can be controlled and you can have a pleasurable spring. Kim notes that “the vast majority” of those with seasonal rhinitis “can have normal lives, generally by avoiding the outdoor allergens as much as possible and taking their medications.”
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